Availability of medical and endovascular therapies for venous thromboembolism: A global survey for World Thrombosis Day

• Published in: Journal of thrombosis and haemostasis 2024-01, Vol.22 (1), p.255-262
• Main Authors: Malerba, Sara A., Fumagalli, Riccardo M., Ay, Cihan, Cesarman-Maus, Gabriela, De Paula, Erich V., Dumantepe, Mert, Guillermo Esposito, Maria Cecilia, Hobohm, Lukas, Sadeghipour, Parham, Samama, Charles M., Sartori, Maria Teresa, Castellucci, Lana A., Barco, Stefano
• Format: Article
• Language: English
• Subjects: Anticoagulants - adverse effects; anticoagulation; Fibrinolytic Agents - adverse effects; Heparin - adverse effects; Heparin, Low-Molecular-Weight - therapeutic use; Humans; survey; Thrombosis - drug therapy; treatment; venous thromboembolism; Venous Thromboembolism - diagnosis; Venous Thromboembolism - drug therapy; Venous Thromboembolism - epidemiology; World Thrombosis Day
• ISSN: 1538-7836; 1538-7836
• DOI: 10.1016/j.jtha.2023.10.002

A global survey was conducted for the 10th anniversary of World Thrombosis Day to assess the availability of VTE treatments, despite known effectiveness and safety, and challenges in uniform implementation. We promoted a global survey and gathered information on the approval status, availability, utilization, occurrence of shortages, and spread of medical and interventional therapies for VTE. Furthermore, we collected information accessing or contacting national or continental medicines agencies, manufacturers or distributors, and online drug repositories. We obtained information covering a total of 69 countries: 33 countries in Europe, 19 in Asia, 7 in the Americas, 9 in Africa, and 1 in Oceania. Unfractionated heparin, low-molecular-weight heparin, vitamin K antagonists were available in almost all countries, but shortages were recorded in 13%, 19%, and 15%, respectively. Direct oral anticoagulants were available in approximately three quarter of surveyed countries. At least one HIT medication was available in 57% of countries and a shortage was reported in 9% of these. Shortage of thrombolytics was recorded in 50% of countries. Overall, at least one type of catheter directed therapy systems was approved for use in 77% of countries and available in 23% of surveyed institutions. Our findings reveal notable geographical discrepancies in the worldwide availability of VTE therapies, the access to which is limited by economical and geopolitical factors. We anticipate that this comprehensive information will play a pivotal role in highlighting the shortcomings of VTE therapies and lack of homogeneous availability globally.